">SDET Engineer - Member enrollment eligibility

9-14 Years Bengaluru

- Factes
- API Testing
- CRM testing
- FRIR
- SQL

Healthcare Domain - Member enrollment eligibility - X12 834 maintenance, retro adjustments, deeming, 820 premium linkage, reconciliation across Medicaid / MA / Duals / MMP / TRICARE / Marketplace Core Skills Needed - Facets (REQUIRED), X12 EDI (834, 820, 270/271), SQL, TOSCA, ADO, enrollment reconciliation

Core technical domain requirements

Facets - REQUIRED: membership/enrollment module testing, subscriber/member configuration, and 834-to-Facets data flow validation

X12 EDI: 834 (Benefit Enrollment Maintenance) - full transaction expertise

Member add/change/term, dependent handling, dual-enrollment scenarios

Retroactive adjustments and deeming logic (Medicaid/MMP/Dual)

820 (Premium Payment) validation linkage

Member eligibility cross-validation (270/271 correlation)

Enrollment reconciliation: source system vs. downstream (enrollment DB claims eligibility)





SQL for member-level data comparisons (effective dates, plan codes, LOB flags)

TOSCA or similar automation tool

LOB knowledge: Medicaid, Medicare Advantage, Duals/MMP, TRICARE, Marketplace

Responsibilities

Design enrollment scenarios including retro, term, and dual-enrollment.

Build/maintain automation; lead 820 linkage and 270/271 correlation testing.

Lead reconciliation between 834 source and downstream member records.

Own offshore enrollment test design across LOBs and deeming logic.

Drive automation coverage and mentor analysts.

Conduct RCA on eligibility and reconciliation discrepancies.

Disclaimer: This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.

📌 SDET Engineer - Member enrollment & eligibility (Bengaluru)
🏢 Quarks Technosoft
📍 Bengaluru